TABLE C.

REPLY FORM.—­VENEREAL DISEASES.

(Confidential.)

I, the undersigned registered medical practitioner,
desire to advise the Committee on Venereal Diseases
of the Board of Health that I had under my personal
care on Saturday, 16th September, 1922,[A] cases of
venereal disease, and of affections attributable to
venereal disease, as under:—­